Petechiae Photos: Appearance, Causes & When to See a Doctor
Petechiae are tiny, pinpoint-sized bleeding spots under the skin. Photos help identify their appearance and assess the severity of the condition.
Things worth knowing about "Petechiae photos"
Petechiae are tiny, pinpoint-sized bleeding spots under the skin. Photos help identify their appearance and assess the severity of the condition.
What are Petechiae?
Petechiae are tiny, pinpoint-sized hemorrhages (less than 2 mm in diameter) caused by the leakage of blood from the smallest blood vessels (capillaries) into the surrounding tissue. They appear as red, red-brown, or purple dots on the skin or mucous membranes and, unlike a common bruise, do not blanch when pressed (no color change in the glass pressure test). This so-called glass pressure test is a simple distinguishing feature: when a glass or spatula is pressed firmly against the skin, ordinary redness fades, while petechiae remain visible.
What do Petechiae Look Like in Photos?
In photos, petechiae typically appear as:
- Small, dot-like red or dark red spots
- Evenly distributed or clustered points on the skin
- Flat, non-raised skin changes
- Commonly found on the lower legs, trunk, face, or mucous membranes
Their size is typically under 2 mm. When the hemorrhages grow larger than 2 mm, they are called purpura, and larger, more extensive bleeding areas are called ecchymoses.
Causes of Petechiae
Petechiae can result from various causes, ranging from harmless to medically serious:
- Mechanical causes: Intense straining, coughing, vomiting, or crying can trigger petechiae on the face or eyelids.
- Infections: Bacterial or viral infections such as meningococcal sepsis, mononucleosis, or measles can cause petechiae.
- Thrombocytopenia: A reduced platelet count (e.g., in immune thrombocytopenia or leukemia) frequently leads to petechiae.
- Coagulation disorders: Conditions such as Disseminated Intravascular Coagulation (DIC) or the use of blood thinners.
- Vasculitis: Inflammatory diseases of the blood vessels.
- Medications: Certain drugs such as aspirin, some antibiotics, or chemotherapy agents.
When to See a Doctor?
Petechiae can be harmless, but they may also be a sign of a serious condition. Medical attention is urgently recommended if:
- Petechiae appear suddenly and in large numbers
- Accompanying symptoms such as fever, stiff neck, severe fatigue, or changes in consciousness are present
- Petechiae spread rapidly
- Bleeding occurs at other locations on the body
Especially in children with petechiae and fever, a doctor should be consulted immediately, as this may indicate a life-threatening meningococcal infection.
Diagnosis
Diagnosis begins with a thorough physical examination and medical history. The following tests are commonly performed:
- Complete blood count including platelet count
- Coagulation values (PT, INR, aPTT)
- Blood or urine cultures if infection is suspected
- Additional laboratory and imaging tests depending on clinical findings
Treatment
Treatment depends on the underlying cause:
- Mechanically caused petechiae (e.g., after straining) usually resolve on their own and require no specific therapy.
- Infection-related petechiae are treated by addressing the infection (e.g., with antibiotics).
- Thrombocytopenia can be managed with medication, platelet transfusion, or causal treatment depending on the underlying condition.
References
- Kasper, D. et al. - Harrison's Principles of Internal Medicine, 21st Edition. McGraw-Hill Education, 2022.
- Schrier, S. L. - Approach to the adult with a suspected bleeding disorder. UpToDate, 2023. Available at: https://www.uptodate.com
- World Health Organization (WHO) - Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. WHO Press, Geneva, 2009. Available at: https://www.who.int
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